There have been two Marburg Virus Disease (MVD) outbreaks in the last two months: one in Equatorial Guinea and one in Tanzania. So far in 2023, the virus has left 12 people dead, more casualties than in the last 10 years combined.
MVD is a viral disease that affects humans as a severe hemorrhagic fever. A member of the Filovirus family (the same as Ebola), it is transmitted from an African fruit bat and also spread from human-to-human contact through bodily fluids.
Although it is not airborne and thus more easily detectable, MVD has a high average fatality rate of 50%, according to the African Union Centers for Disease Control and Prevention (CDC). Currently, there are no approved vaccines, and the treatment is based on prevention, surveillance, and early clinical care.
Where Is The Virus Now, And Where Else Has It Been?
The first outbreak of this year took place in Equatorial Guinea, in the Kie-Ntem province, and was reported on February 13th. By March 22nd, nine confirmed cases were reported by the World Health Organization (WHO). So far, seven people have died.
Just a few days ago, on March 21st, a second outbreak was reported in the Kagera region in Tanzania. Health Minister Ummy Mwalimu explained that so far, five people have died (out of eight confirmed cases) and that Tanzanian health authorities are taking measures to contain the spread of the virus, as reported by DW.
MVD is not a new disease. Having been active since the 1960s, the virus had previous outbreaks or sporadic cases reported in Uganda, Angola, the Democratic Republic of Congo, Kenya, and South Africa. Two isolated cases were carried by tourists to the Netherlands and the United States in 2008, with no further transmission detected. In Africa, the worst outbreaks were reported in Angola and the DRC between 1998 and 2005, with almost 400 people dead. 2023 is the year with the most deaths reported in more than 15 years.
What Is MVD Exactly?
First recognized in humans in 1967, the Marburg Virus then affected workers of research facilities in Germany and Yugoslavia (now Serbia). Spreading afterward to other lab workers and family members, that first encounter left a total of 31 people ill and seven dead.
The virus was traced to African Green Monkeys imported from Uganda. As a zoonotic disease (carried from animals to humans), its current medium and reservoir host is the African fruit bat, which explains why outbreaks take place in mines and communities related to its habitat in Sub-Saharan Africa, and why it is not very likely to occur outside the continent.
After infection, MVD has an incubation period of two to nine days, not being transmissible during that window frame. Symptoms then appear as fever, headaches, chills, and muscle pains; and around the fifth day since onset, they can evolve to delirium, severe weight loss, shock, organ dysfunction, and massive hemorrhaging. According to the African CDC, the death rate varies between 23 to 90%.
What To Expect Now?
Currently, there is no approved vaccine for MVD, with hydration and early supportive care as the only measures known to improve survival rates. According to the WHO, efforts of national authorities, surveillance, testing, and clinical care; as well as prevention, public awareness campaigns, and epidemiological investigation are the only tools to control the outbreaks.
Dr. Ahmed Ogwell, director of the African CDC, tweeted recently that efforts are being deployed internationally to strengthen response and “limit risks of spread.” However, there are several vaccines in the works, as reported by NBC news, that were commissioned by the WHO in 2021 to a group of vaccine developers, researchers, and government officials.
In the meantime, a vaccine by the US NIAID has shown promising results in phase 1 of human studies and could be deployed in areas with current and future outbreaks, if proven to be safe and effective. A hope for the virus’ eradication in Africa, and a long-time debt to countries in the Global South.